For those of you not familiar with Suboxone, it’s an outpatient treatment for opiate addiction. A main advantage of Suboxone is that patients can take the pills at home, instead of having to go to a methadone clinic every day. For a motivated person who has things to do (like, say, a full-time job), Suboxone is important. Unfortunately, providers have to be specially certified medical doctors–no NP’s allowed. There aren’t many providers in my community, although Suboxone is covered by our state’s insurance. I saw a patient last week who came in with a complaint of “going through withdrawl.” He had attempted to enroll in a Suboxone program through our clinic, but our only certified provider wasn’t taking new patients. So he found a private doctor who is willing to take new patients…for a fee. You see, this provider doesn’t take insurance. And the cost for an initial visit for Suboxone? $400. Plus $75 every two weeks for the new prescriptions. And that doesn’t cover the cost of the pills. My patient had been taking suboxone TID for a few weeks when he ran out of money–thus the withdrawl.
Now, I know that heroin is an expensive habit, so the patients have to be getting the money from somewhere, right? And addicts are a difficult and mostly undesirable bunch to work with. But it just doesn’t seem fair to me to take cash from a struggling father when insurance would reimburse for the same thing (I know…at a lower rate). I guess that’s why I never feel tempted to go into private practice.